Nardostachys jatamansi (Jones) DC. (Valerianaceae) is used in large quantities in the preparation of Ayurvedic and Unani drugs (1, 2). The decoction of the roots of this plant have been used for centuries in Ayurveda for epilepsy, hysteria, syncope, and mental weakness (3). Gupta et al. (4) reported that the ethanolic extract was found to be the most active and abolished the tonic extensor response in 50% of rats subjected to maximal electroshock seizures (MES). Jatamansone was found to be more effective than diphenylhydantoin (DPH) and the essential oil of N.jatamansi in MES. A preliminary study in our laboratory showed that the alcoholic extract of the roots of N. jatamansi increased the seizure threshold when tested against MES (25). Many investigations have been performed to determine the role of neurotransmitters in seizure mechanism. Several reports are available on the role of monoamine metabolism (5-8) and inhibitory amino acid metabolism (9, 10) in experimental as well as clinical seizures. But very few reports are available on the scientific evaluation of the effect of N.jatamansi extract on the activity of the brain. Hence, the present study was undertaken to evaluate the effect of the extract of N.jatamansi on biogenic amines and inhibitory amino acids in rat brain. Materials and Methods Animals Adult male albino Wistar rats weighing 180-250 g were used in the present study. The rats were housed in colony cages at an ambient temperature of 25 2°C and relative humidity of 50 10% with a light-dark cycle of 12 h each. They were fed standard pellet chow (purchased from Hindustan Lever, India) and water ad libif urn. In order to avoid the interference by the circadian rhythm in central nervous system amine content and turnover, all the experiments were performed at the same time of the day (8.00-11.00 am.). Drugs The roots of N.jafarnansi DC, (Valerianaceae) were purchased locally and identified by a pharmacognosist of the Department of Pharmacognosy, College of Pharmacy, Manipal where the voucher specimen has been deposited (No. 004083) aod were dried in shade, cleaned, and powdered to prepare the alcoholic extract. Extraction procedure and yield One kg of moderately powdered roots of N.jafamansi was extracted by refluxing with 95% alcohol in a Soxhlet extractor for 6-8 h. The extract was evaporated to dryness imder reduced pressure and temperature using flash evaporation and the dried residue was weighed and stored at 4°C. The yield of dry extract from the crude powder of N.jafarnansi was 8 %.

Introduction: Cytokines and granulocyte elastase produced in sepsis cleave a disintegrin and metalloprotease with thrombospondin type I motif 13 (ADAMTS13) and deplete its levels. By this mechanism, sepsis results in microangiopathic hemolytic anemia (MAHA) with thrombocytopenia. Hence, the hypothesis is that plasmapheresis may help in sepsis-induced thrombotic microangiopathy (sTMA), by removing the factors responsible for low levels of ADAMTS13. In tropical countries like India, the contribution of sepsis to intensive care unit (ICU) mortality is high; and hence, it is essential to look out for newer modalities of sepsis treatment. There is abundant literature on the use of plasmapheresis in sepsis but data on its use in sTMA are limited, thus necessitating further research in this field. Case description: This case series studies the outcomes of five patients admitted with sTMA in the ICU and attempts to evaluate the effectiveness of plasmapheresis in improving their outcomes. All patients diagnosed with sTMA and treated with plasmapheresis, between January 2016 and August 2018 at our tertiary care center, were selected for the study. The diagnosis of sepsis was based on sepsis-3 definition. Results: Four different gram-negative organisms were found to have caused MAHA, with the commonest source being either urinary tract infection (UTI) or lower respiratory tract infection. Three of five patients required hemodialysis and two had disseminated intravascular coagulation (DIC). All five had good outcome and recovered well from the acute episode post plasmapheresis. Discussion: In two of five patients, the initial smear was negative and hence the need for repeated examination of the peripheral blood smear should be kept in mind in cases of sTMAs. The median of the number of plasmapheresis sessions required in sTMA is six, which is lesser than that required for primary thrombotic thrombocytopenic purpura (TTP). Hence, the duration of central line placement and the risk of catheter-related complications are low. Based on the observations made in this case study, further exploratory studies are required to evaluate the efficacy of plasmapheresis in sTMA secondary to tropical infections.